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Pheochromocytoma may reduce bone mass at the lumbar spine
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Adults with pheochromocytoma had lower bone mass at the lumbar spine compared with adults with nonfunctional adrenal incidentaloma, according to recent study findings.
Further, bone resorption in these adults became suppressed following adrenalectomy, according to the researchers.
Jung-Min Koh, MD, PhD, of the division of endocrinology and metabolism at Asan Medical Center, University of Ulsan College of Medicine in Korea, and colleagues evaluated data from the Asan Medical Center cohort, a subset of the Co-work of Adrenal Research study, on 31 adults with histologically confirmed pheochromocytoma (cases; mean age, 50.2 years) and 280 adults with nonfunctional adrenal incidentaloma (controls; mean age, 54.5 years). Researchers sought to describe the link between the sympathetic nervous system and the skeleton.
Researchers performed multiple linear regression analyses to determine the independent associations of urinary fractionate metanephrines with bone mineral density and bone turnover markers. Higher urinary metanephrine levels were significantly associated with lower BMD at the lumbar spine but not the femur neck or total hip after adjustment for potential confounders. BMD at the lumbar spine was inversely associated with urinary normetanephrine. Serum C-terminal telopeptide of type 1 collagen (CTX) was positively associated with urinary metanephrine and normetanephrine levels whereas no association was observed between the urinary levels and bone-specific alkaline phosphatase (BSALP).
The case group had 7.2% lower bone mass at the lumbar spine compared with the control group after adjustment for confounding factors. The case group also had 33.5% higher serum CTX level compared with the control group whereas no significant difference was observed between the two groups for serum BSALP level.
The case group had 2.54-fold higher odds for lower BMD at the lumbar spine, femur neck or total hip compared with the control group (P = .056).
Among the case group, information about bone turnover markers after adrenalectomy was available for 14 participants; serum CTX levels decreased by 35.2% after adrenalectomy whereas no significant changes were observed in BSALP.
“The data presented here provide important evidence that sympathetic overstimulation can contribute to adverse effects on human bone through the increase of bone loss as well as bone resorption, and may have clinical implications justifying aggressive treatment for pheochromocytoma in terms of bone health in addition to cardiovascular risks,” the researchers wrote. “Additional experimental studies are necessary to unravel the complex mechanisms linking the [sympathetic nerve system] and bone metabolism in humans.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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